TY - JOUR
T1 - IL-10 and IL-12 (P70) Levels Predict the Risk of Covid-19 Progression in Hypertensive Patients
T2 - Insights From the BRACE-CORONA Trial
AU - Moll-Bernardes, Renata
AU - de Sousa, Andrea Silvestre
AU - Macedo, Ariane V.S.
AU - Lopes, Renato D.
AU - Vera, Narendra
AU - Maia, Luciana C.R.
AU - Feldman, André
AU - Arruda, Guilherme D.A.S.
AU - Castro, Mauro J.C.
AU - Pimentel-Coelho, Pedro M.
AU - de Albuquerque, Denílson C.
AU - de Paula, Thiago Ceccatto
AU - Furquim, Thyago A.B.
AU - Loures, Vitor A.
AU - Giusti, Karla G.D.
AU - de Oliveira, Nathália M.
AU - De Luca, Fábio A.
AU - Kotsugai, Marisol D.M.
AU - Domiciano, Rafael A.M.
AU - Santos, Mayara Fraga
AU - de Souza, Olga Ferreira
AU - Bozza, Fernando A.
AU - Luiz, Ronir Raggio
AU - Medei, Emiliano
N1 - Publisher Copyright:
© 2021 Moll-Bernardes, de Sousa, Macedo, Lopes, Vera, Maia, Feldman, Arruda, Castro, Pimentel-Coelho, de Albuquerque, de Paula, Furquim, Loures, Giusti, de Oliveira, De Luca, Kotsugai, Domiciano, Santos, de Souza, Bozza, Luiz and Medei.
PY - 2021
Y1 - 2021
N2 - Background: Cardiovascular comorbidities such as hypertension and inflammatory response dysregulation are associated with worse COVID-19 prognoses. Different cytokines have been proposed to play vital pathophysiological roles in COVID-19 progression, but appropriate prognostic biomarkers remain lacking. We hypothesized that the combination of immunological and clinical variables at admission could predict the clinical progression of COVID-19 in hypertensive patients. Methods: The levels of biomarkers, including C-reactive protein, lymphocytes, monocytes, and a panel of 29 cytokines, were measured in blood samples from 167 hypertensive patients included in the BRACE-CORONA trial. The primary outcome was the highest score during hospitalization on the modified WHO Ordinal Scale for Clinical Improvement. The probability of progression to severe disease was estimated using a logistic regression model that included clinical variables and biomarkers associated significantly with the primary outcome. Results: During hospitalization, 13 (7.8%) patients showed progression to more severe forms of COVID-19, including three deaths. Obesity, diabetes, oxygen saturation, lung involvement on computed tomography examination, the C-reactive protein level, levels of 15 cytokines, and lymphopenia on admission were associated with progression to severe COVID-19. Elevated levels of interleukin-10 and interleukin-12 (p70) combined with two or three of the abovementioned clinical comorbidities were associated strongly with progression to severe COVID-19. The risk of progression to severe disease reached 97.5% in the presence of the five variables included in our model. Conclusions: This study demonstrated that interleukin-10 and interleukin-12 (p70) levels, in combination with clinical variables, at hospital admission are key biomarkers associated with an increased risk of disease progression in hypertensive patients with COVID-19.
AB - Background: Cardiovascular comorbidities such as hypertension and inflammatory response dysregulation are associated with worse COVID-19 prognoses. Different cytokines have been proposed to play vital pathophysiological roles in COVID-19 progression, but appropriate prognostic biomarkers remain lacking. We hypothesized that the combination of immunological and clinical variables at admission could predict the clinical progression of COVID-19 in hypertensive patients. Methods: The levels of biomarkers, including C-reactive protein, lymphocytes, monocytes, and a panel of 29 cytokines, were measured in blood samples from 167 hypertensive patients included in the BRACE-CORONA trial. The primary outcome was the highest score during hospitalization on the modified WHO Ordinal Scale for Clinical Improvement. The probability of progression to severe disease was estimated using a logistic regression model that included clinical variables and biomarkers associated significantly with the primary outcome. Results: During hospitalization, 13 (7.8%) patients showed progression to more severe forms of COVID-19, including three deaths. Obesity, diabetes, oxygen saturation, lung involvement on computed tomography examination, the C-reactive protein level, levels of 15 cytokines, and lymphopenia on admission were associated with progression to severe COVID-19. Elevated levels of interleukin-10 and interleukin-12 (p70) combined with two or three of the abovementioned clinical comorbidities were associated strongly with progression to severe COVID-19. The risk of progression to severe disease reached 97.5% in the presence of the five variables included in our model. Conclusions: This study demonstrated that interleukin-10 and interleukin-12 (p70) levels, in combination with clinical variables, at hospital admission are key biomarkers associated with an increased risk of disease progression in hypertensive patients with COVID-19.
KW - COVID-19
KW - biomarker
KW - cytokine
KW - hypertension
KW - inflammation
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85130808823&partnerID=8YFLogxK
U2 - 10.3389/fcvm.2021.702507
DO - 10.3389/fcvm.2021.702507
M3 - Article
AN - SCOPUS:85130808823
SN - 2297-055X
VL - 8
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
M1 - 702507
ER -